Our 31 year old patient has repeat bloods including a few extra. FBC confirms leucocytosis with WCC 38, and basophilia 3.8. Platelets are normal. U&Es and LFTs are normal. No organomegaly on clinical exam.

On further questioning, this 31 year old female patient has no relevant PMH. She has a FH of familial hypercholesterolaemia but maintains regular exercise, good diet and doesn’t smoke. She works as a primary school teacher, has been married for 2 years and has no children, but is planning a family in the near future.

How would you explain the disease/prognosis to this young patient? What would be the options for 1st line treatment?

Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to evolve over the coming week so keep checking #TeamHaem on Twitter for more information.